Emergence of a Deadly Coronavirus

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People who have had multiple bouts of COVID-19 or had it severely, and those who were unvaccinated when first infected, had an increased risk of developing long COVID, according to a new study by Stony Brook University researchers.

The study looked at 2,522 people in the program who had a positive COVID-19 test between March 2020 and February 2024 and determined 475 had long COVID. Of that number, 403 or almost 85%, had been infected with the virus that causes COVID several times.

The study was conducted by researchers at the Renaissance School of Medicine at Stony Brook University in conjunction with the Stony Brook World Trade Center Health and Wellness Program.

Everyone in the study was considered an essential worker and most were first responders. The program treats and monitors people with health problems related to the Sept. 11, 2001, terrorist attacks.

"We found a significant association" between the risk of long COVID and multiple reinfections, severity and vaccination status at first infection, according to the report, published this month in "The Lancet Regional Health-Americas" journal.

The study said a "large proportion" of participants who were not vaccinated at the time of their first infection experienced long COVID.

Lead author and Stony Brook professor Sean Clouston said researchers accounted for different medical conditions but that age and gender didn’t really make a difference other than if they contributed to the severity of the infections.

"We had some younger people who had more severe COVID that was associated with a higher risk of long COVID," said Clouston, a professor in the department of Family, Population and Preventive Medicine at the Renaissance School of Medicine.

"It really wasn’t the age anymore, it was the COVID.

Experts say the continuing study of long COVID is vital, because while deaths and severe illness from COVID-19 have dropped since the early days of the pandemic, there are still many questions about the lingering impacts of an infection and it's still not fully understood.

"Long COVID is now the threat," said Dr. Reynold A. Panettieri Jr., vice chancellor at the Rutgers Institute for Translational Medicine and Science, who was not involved in the study.

"Before it was death. People didn’t want to go into intensive care and be on a ventilator," he said. "Now if you get it and you get it more frequently, the potential for long COVID and sustained symptoms is greater."

While the COVID-19 vaccines have been important in decreasing the number of people who get severely sick and die from the disease, they have not prevented or stopped infections, said Dr. Benjamin Luft, an infectious disease specialist and director of the Stony Brook World Trade Center Health and Wellness Program.

"Long COVID-19 has been so debilitating and so harmful that you really need something that is effective against that — whether that’s a vaccine or a therapeutic," Luft said.

The number of people getting the COVID-19 vaccine overall has dropped compared to initial years, as some people express frustration with its inability to prevent infections, though the rate grew in 2024 compared to the prior year.

"Instead of saying, ‘We’re not going to get the vaccine,’ people should be asking for a better vaccine … one that prevents the infection," he said. "We need new and better strategies for the development of the next generation vaccine."

Susan Scarbro stares down a bowling lane at the distant pins.

She hears a sound that breaks her focus. Was that a cough? Will her mask protect her?

COVID-19 remains a very present threat for the 55-year-old. Scarbro has multiple immune disorders, making her vulnerable to infection.

“Any minute anybody could cough, just incidentally,” said Scarbro, who lives in Sunset Beach, North Carolina. “And that cough could be the one thing that could make me sick.”

This month marks the fifth anniversary of the first confirmed case of COVID-19 in the U.S. The virus would go on to kill 1.2 million Americans and disrupt countless lives.

While the pandemic’s emergency phase ended in May 2023, the threat of infection remains a governing force in the lives of people like Scarbro. They protect themselves from the virus with masks and isolate themselves in small family bubbles. Some grasp for unproven strategies — gargling with antiseptic mouthwash, carrying a personal carbon dioxide monitor to check the ventilation of indoor spaces.

In online support groups, they trade research about the danger of repeat infections and cognitive impairment. They miss the empathy they felt during the early days of the pandemic. Some have lost friendships, but they strive to maintain the social ties that are important to mental health.

Scarbro’s bowling league helps her feel connected to her neighbors. But recently, she’s detected more stares and skeptical looks from strangers when she bowls in a mask.

“There was more respect and understanding, but now they’re over it,” she said. “They expect me to be over it, but they don’t understand that even before COVID-19, these were the precautions I needed to take.”

Most Americans have developed some level of protection against severe disease from previous COVID-19 infections, vaccinations or both. But immunocompromised people like Scarbro, who has common variable immune deficiency, must be constantly vigilant. Unlike the flu, COVID has not settled into a seasonal pattern.

“There’s never a time when they can relax a little bit,” said Andrew Pekosz, a virologist at Johns Hopkins University. “That’s a really challenging and exhausting thing to ask someone to do.”

Who are the people still cautious about COVID-19? They include young caregivers of vulnerable relatives, people with chronic health conditions and families rallying around a loved one. In interviews with The Associated Press, they talked about how they manage the trade-offs and the toll of isolation on their mental health.

How hard is it to put a mask on?’
Before the pandemic, Bazia Zebrowski, 61, of Newbury, Ohio, dined out, shopped for groceries and took her dog, Shadoh, to the park. When she felt well, she occasionally could get together with friends despite having myalgic encephalomyelitis, a condition formerly known as chronic fatigue syndrome that causes inflammation, immune system problems, fatigue and pain.

Now she keeps close to home, venturing out only for medical appointments. Her husband does the shopping and wears a mask at his workplace.

They have not had COVID-19 and hope their luck holds. Getting sick would be a disaster, she said, potentially triggering a relapse or superimposing long COVID-19 onto her illness.

“I don’t consider myself COVID cautious. I consider myself COVID competent,” Zebrowski said. “Cautious would imply that I have an unreasonable fear of something. I do not have an unreasonable fear of this disease.”

What does Zebrowski miss about pre-pandemic times? “I miss the illusion that people are willing to care for each other,” she said. “How hard is it to put a mask on? It rattles your faith in humankind … (you learn) how little the people in your life understood how sick you were to begin with.”

Trauma is part of the experience of having a chronic illness, said DePaul University psychologist Leonard Jason, who has studied myalgic encephalomyelitis for more than three decades.

“Then you’re traumatized by the societal reaction to the illness,” he said.

Protecting a partner
Some people aren’t sick themselves but are taking precautions to protect a family member. Steve Alejandro, 42, of Wentzville, Missouri, calls himself a COVID shielder.

His wife, Ashley Alejandro, 44, also has myalgic encephalomyelitis. “She’s got maybe four good hours a day,” Alejandro said. “There’s not a thing in the world I wouldn’t do to protect those four hours.”

In Miami, Kira Levin is the primary caregiver for her 98-year-old grandmother. She said the thought of getting COVID-19 and risking her grandmother’s health is So, at a July wedding, the 29-year-old was the only bridesmaid and attendee in a mask — an N95 layered with a pretty mask to match the bride’s green color scheme.

“I didn’t take off the mask for pictures and nobody asked me to,” Levin said. “And I felt incredibly grateful for that.”

‘COVID Cautious’ dating
Denver-based sisters Jacqueline and Alexa Child stay masked while going to concerts and dining outdoors with friends who don’t share the same level of COVID-19 caution.

“We have done everything we possibly could to maintain our mental health and our social life,” said Jacqueline, who has an immune disease that makes her vulnerable to infections. “There’s nothing worse than being disabled and isolated. As someone who has been disabled and isolated, I don’t want that isolation part.”

Jacqueline, 30, and her sister Alexa, 34, launched a dating app called Dateability in 2022 for people who are disabled or chronically ill, though all are welcomed. Users can add a “COVID Cautious” tag to their profiles to signal they’re interested in meeting others who take precautions. The Child sisters say 10% of their 30,000 users add “COVID Cautious” to their dating profiles.

“It’s a market that we didn’t expect to target but we happily accept,” Jacqueline said.

Alexa said the precautions started as a way to protect Jacqueline, “but they’re no longer about that.” She’s trying to avoid long COVID, a long-term disability.

Tossing aside the threat of long COVID is hard to imagine for Yale University immunologist Akiko Iwasaki. Though people have been studying the virus since its emergence, she said scientists still don’t know how pieces of the virus can stick around in the blood of some people for more than a year after they’ve recovered from the illness.

Iwasaki still wears masks indoors and stays up to date with vaccines.

“I just can’t afford to get sick and become chronically ill,” she said. “I feel that we really are in a position to be able to better understand the disease, to help millions of people.”

A new normal
While Scarbro understands that others are ready to return to “normal,” it’s not that easy for her or her family. It’s true for many others with chronic immune illnesses, said Jorey Berry, CEO of Immune Deficiency Foundation.

“While the rest of the world is able to kind of go back to their regular lives, our community doesn’t have that luxury,” she said.

And as the world turns back to pre-COVID life, Scarbro’s family is doing what they can to keep her healthy — but not in complete isolation.

“I feel very scared about the future,” she said. “I know that people are done, and I respect that, but it’s only going to make it harder for me and my family to keep me safe.”

The Central Intelligence Agency said Saturday that it’s more likely a lab leak caused the Covid-19 pandemic than an infected animal that spread the virus to people, changing the agency’s yearslong stance that it couldn’t conclude with certainty where the pandemic started.

The agency made its new assessment public two days after former Republican lawmaker John Ratcliffe was sworn in as its new leader.

“We have low confidence in this judgement and will continue to evaluate any available credible new intelligence reporting or open-source information that could change CIA’s assessment,” an unnamed CIA spokesperson wrote in an email sent to reporters Saturday.
The statement didn’t include any additional details about what led the agency to change its assessment and whether it had intelligence that would add weight to the theory that the virus had leaked from a research lab in Wuhan, China.

The “CIA continues to assess that both research-related and natural origin scenarios of the Covid-19 pandemic remain plausible,” the statement said.

A U.S. official granted anonymity to share private details about the assessment said former CIA director William Burns had told analysts that they needed to take a position on the origins of the Covid-19 pandemic, but that he was agnostic on potential theories.

A new CIA analysis of the intelligence it had on the virus’ origin was completed and published internally before Ratcliffe’s arrival, the U.S. official said. Ratcliffe authorized its public release, the official added.

Why it matters

Congressional Republicans have embraced the unproven lab leak theory, pointing to how the first cases of Covid-19 were reported in Wuhan, where a virology lab was researching coronaviruses at the time.

Still, many virologists have published studies supporting a likely natural origin, arguing that the virus may have spread amongst people who were exposed to animals infected with the virus that were being sold at a wet market in the city.

The intelligence community had been split on what sparked the pandemic, according to an unclassified assessment from the Office of the Director of National Intelligence published in 2023. More agencies at the time leaned toward a natural origin for the pandemic.

The Federal Bureau of Investigation has backed the lab leak hypothesis with moderate confidence, while the Department of Energy expressed low confidence in the theory.
Ratcliffe, who was the director of national intelligence during President Donald Trump’s first term, suggested at a Heritage Foundation event last summer that the CIA’s failure to come to a conclusion about the pandemic’s potential origin reflected “political and financial considerations” instead of the agency’s inability to do so.

Ratcliffe said at the same event that when he became national intelligence director in 2020 — at the height of the Covid-19 pandemic — he asked to see the evidence that had led the intelligence community to conclude a few days earlier that the virus had natural origins.

“The vast preponderance of it said exactly the opposite, said exactly what we’ve concluded, is that most likely, all of the intelligence that we had — circumstantial though it may be — pointed towards this being a research-related incident, not naturally occurring,” Ratcliffe said at the event.

Ratcliffe told Breibert in an interview Thursday that “why the Central Intelligence Agency has been sitting on the sidelines for five years in not making an assessment about the origins of Covid” was a day one priority for him.

Aside from the potential curse of long COVID, people who've had the SARS-CoV-2 virus may be more likely to develop high levels of biomarkers for brain proteins linked to Alzheimer's disease, scientists report in a new study.

The average estimated effect of the virus on beta amyloid proteins was comparable to the effect from four years of aging, researchers found.

The difference was most pronounced in patients who'd been hospitalized with severe COVID-19, the study found, or in those with underlying risk factors for dementia, like high blood pressure.

These results hint at yet another insidious effect of COVID, the researchers write, suggesting even mild or moderate cases might speed up biological processes promoting the accumulation of beta amyloid proteins, which previous research has linked with Alzheimer's.

There are important caveats to note, however. For one, this was an observational study, so it can establish correlation but not causation.

And even if COVID does raise the risk for these biomarkers, we don't know if that effect would be unique to SARS-CoV-2, or if it could be similarly triggered by other pathogens like influenza.

The blood biomarkers used in this study are also fairly new, the authors acknowledge, and debatably reliable as clinical tools.

Nonetheless, given the devastating effects of Alzheimer's and its uncertain origins, clues like this could be valuable pieces of an urgent puzzle.

This does fit with past research suggesting some types of infections might increase Alzheimer's risk for some people, says neuroscientist Eugene Duff from Imperial College London.

"Our findings suggest COVID-19 may drive changes which contribute to neurodegenerative disease," Duff says. "We think this may be due to the inflammation triggered by the disease, although how this inflammation might impact the brain and changes to amyloid is not yet fully clear.

"We can't say that catching the SARS-CoV-2 virus directly causes these changes, or if it does, by how much a single episode of infection increases someone's risk," he notes.

"But our findings do suggest that COVID-19 may increase the risk of Alzheimer's in the future – as has been suggested in the past for other kinds of infections – especially among people with pre-existing risk factors," he says.

Despite its prevalence, Alzheimer's is still shrouded in mystery. Much attention has focused on beta amyloid plaques, although it's unclear what role those play, and whether they cause the disease or vice versa.

Beta amyloid proteins are common in the body, serving an array of purposes. Their accumulation into clumps, or plaques, is what's troubling.

These plaques are strongly associated with Alzheimer's, and while their role remains murky, they might trigger symptoms of the disease by damaging neurons in the brain, the study's authors note.

Given the uncertainty, it seems wise to at least pay attention if something correlates with suspected Alzheimer's biomarkers – in this case, ratios of different forms of beta amyloid.

Duff and his colleagues looked at data from 1,252 participants in the UK Biobank, ranging from 46 to 80 years old. This included data collected both before and after confirmed SARS-CoV-2 infections.

They compared biomarkers from former COVID patients with those from participants who have similar traits but no evidence of past infections.

People with a COVID history were likelier to have specific changes in blood proteins that previous research has linked to beta-amyloid pathology in the brain, the study found.

The magnitude of change recalled that of a genetic variant known as APOE4, which is an established risk factor for Alzheimer's disease, the researchers note.

The change was also more dramatic among people who'd been hospitalized for COVID – and for those with known Alzheimer's risk factors, like hypertension.

"We've long suspected a link between infectious diseases and the progression of neurodegenerative disease – both with viral diseases, like herpes and influenza, and with some chronic bacterial infections," says senior author Paul Matthews, a neurologist in the UK Dementia Research Institute at Imperial College London.

"This latest analysis suggests that SARS-CoV-2 infection could potentially be another of these drivers of disease, particularly among those with underlying risk factors," he says.

A small study identified potential immunologic patterns associated with post-vaccination syndrome, a very rare condition with neurologic symptoms that occurs in some people following a COVID-19 vaccine.

Immune cell populations of people with post-vaccination syndrome had lower levels of effector CD4 T cells and higher levels of CD8 T cells that secrete tumor necrosis factor (TNF) compared with healthy controls, reported Akiko Iwasaki, PhD, of Yale University School of Medicine in New Haven, Connecticut, and co-authors in a preprint posted on medRxiv. The paper has not been peer-reviewed.

Post-vaccination syndrome patients had lower levels of antibodies against the SARS-CoV-2 spike protein versus healthy controls, likely because they stopped getting more vaccine doses, the researchers said. Evidence of recent Epstein-Barr virus (EBV) reactivation was seen more frequently in people with post-vaccination syndrome than in vaccinated people without the condition.

A subset of post-vaccination syndrome patients also had higher levels of circulating spike protein in their blood. Detectable levels of the S1 subunit of the spike protein were seen in plasma up to 709 days after the most recent known exposure.

Finding the spike protein in circulation at such a late time point was surprising, Iwasaki said.

"There is very little known about the biology of post-vaccination syndrome," Iwasaki told MedPage Today. "We do not know how spike protein is present at such a long time from vaccination. We also do not know whether the spike protein is leading to illness in people."

"Other studies have found that spike protein alone can induce fibrin clots and induce neuroinflammation," she added. "We need to study this in larger patient groups and use multiple approaches to validate our findings."

Persistent spike proteinopens in a new tab or window has been associated with long COVID, as has EBV reactivationopens in a new tab or window. Like long COVID patients, people with post-vaccination syndrome often experience exercise intolerance or have persistent neurologic problemsopens in a new tab or window. A prior studyopens in a new tab or window reported that S1 spike expression on monocytes was elevated in people with post-vaccination syndrome who had long COVID-like symptoms.

"Post-vaccination syndrome and long COVID have many overlapping symptoms, but there are some distinct ones," Iwasaki noted. "This possible overlap could be mediated by common pathological drivers such as spike protein or EBV reactivation."

The immune findings came from an analysis of 42 people with post-vaccination syndrome (29 females and 13 males, all with no pre-existing comorbidities) and 22 controls who did not have post-vaccination syndrome after receiving a COVID vaccine (11 females and 11 males) from the LISTENopens in a new tab or window study. All blood samples were collected between December 2022 and November 2023.

The median age of participants was 42.5 years. The most frequent symptoms reported by those with post-vaccination syndrome were excessive fatigue (85%), tingling and numbness (80%), exercise intolerance (80%), brain fog (77.5%), difficulty concentrating or focusing (72.5%), trouble falling or staying asleep (70%), neuropathy (70%), muscle aches (70%), anxiety (65%), tinnitus (60%), and burning sensations (57.5%).

The study is limited by its small sample size and the fact that post-vaccination syndrome is "a very, very heterogeneous" disorder, noted Gregory Poland, MD, president of the Atria Health and Research Institute in New York City and emeritus editor-in-chief of the Vaccine journal.

"Despite these limitations, the researchers found interesting data that need further study, particularly in the arena of hyper-innate immune system activation and its consequences, persistent S1 protein circulating, and immune cell subset perturbations," Poland told MedPage Today.

My clinical impression is that post-vaccination syndrome is real," he observed. "Collectively, my impression is that this adds to the growing body of literature and clinical experience suggesting that in rare cases, mRNA-based COVID vaccines can induce immune, autoimmune, viral reactivation, and other perturbations in susceptible individuals."

Much larger studies of very carefully defined and phenotyped individuals are needed to be sure of that statement, Poland said.

Blood flow problems within the lungs could be driving long COVID in some children, according to scans using an advanced form of MRI.

Children and teens with long COVID appear to have significantly reduced blood flow through their lungs, researchers reported in the journal Radiology.

This could cause fatigue -- one of the more common symptoms of long COVID in children – due to lower levels of oxygen distributed throughout the body via the bloodstream, researchers said.

The study’s results might explain why kids with normal breathing still suffer from fatigue related to long COVID, researchers said.

“Parents should understand that their children’s persistent symptoms after COVID-19 may have a measurable physiological basis, even when standard medical tests appear normal,” lead researcher Dr. Gesa Pöhler, a senior physician of diagnostic and interventional radiology at Hannover Medical School in Germany, said in a news release.

Long COVID involves symptoms that develop weeks after a person’s initial COVID-19 infection. These symptoms can persist for months or even years.

The most common symptoms of long COVID in children are chronic fatigue, shortness of breath, headache, heart palpitations and poor concentration, researchers said in background notes.

For the study, researchers turned to a type of imaging scan called phase-resolved functional lung (PREFUL) MRI.

This form of MRI can analyze the movement of air in and out of the lungs, as well as blood flow through the lungs.

Adults with long COVID typically are examined using chest CT scans, but doctors are loath to use the same imaging technology on children because it exposes kids to radiation, researchers said.

MRI scans use magnetic waves and can be performed while a patient breathes freely, making it a more suitable procedure for children, researchers said.

Researchers performed PREFUL MRI scans on 54 patients between 11 and 17 years of age. Half had been diagnosed with long COVID, and the other half were healthy.

Compared to the healthy kids, children and teens with long COVID had reduced blood flow through their lungs, results show.

Furthermore, all but one of these kids with long COVID suffered mainly from fatigue.

“Importantly, the severity of fatigue symptoms correlated with these blood flow changes, suggesting a possible biological basis for the patients’ ongoing symptoms,” Pohler said.

They theorize that a person’s initial bout with COVID might cause lasting damage to the tiny blood vessels in the lungs, leading to this reduction in blood flow.

mRNA vaccination against SARS-CoV-2 was tied to a 57% and 73% lower risk of having at least one or two long-COVID symptoms, respectively, in US children ages 5 to 17 years, according to a case-control study led by researchers from the Centers for Disease Control and Prevention (CDC).

The four-site study involved 622 children who were eligible for COVID-19 vaccination when they were infected with the Omicron variant and who completed a post-COVID condition (PCC) survey at least 60 days later. They were enrolled from the Pediatric Research Observing Trends and Exposures in COVID-19 Timelines (PROTECT) study, a longitudinal SARS-CoV-2 surveillance cohort convened in July 2021.

Persistent symptoms can be debilitating
Participants were tested for SARS-CoV-2 infection each week from December 2022 to May 2023, and they or their guardians completed surveys about ongoing symptoms at least 1 month post-infection.

The study included 28 case-participants (those reporting PCC symptoms; 5%) and 594 controls (95%). The median age was about 10 years, roughly half were girls, and 57% of case-participants and 77% of controls had received at least two COVID-19 vaccine doses, 99% of them with the Pfizer/BioNTech vaccine.

"Although children typically experience mild symptoms from SARS-CoV-2 infection, PCC can develop following mild or severe COVID-19 illness, and PCC symptoms can be prolonged, debilitating, and contribute to school absenteeism," the researchers noted.

The findings were published yesterday in JAMA Network Open.

Overall protection likely even higher
Several children reported no symptoms, and none were hospitalized. After adjusting for demographic factors, number of COVID-19 symptoms during infection, and baseline health, COVID-19 vaccination was linked to a lower risk of at least one and two PCC symptoms (adjusted odds ratios [aORs], 0.43 and 0.27, respectively).

"The aORs correspond to an estimated 57% and 73% reduced likelihood of 1 or more and 2 or more PCC symptoms, respectively, among vaccinated vs unvaccinated children," the study authors wrote.

The aORs of respiratory and nonrespiratory PCC symptoms were 0.28 and 0.49, respectively. Of the 28 participants reporting at least one symptom, 57% said their symptoms affected their ability to function (aOR, 0.25).

Findings boost case for keeping current with vaccine doses
"Because both case and control participants had SARS-CoV-2 infection, the overall protection against PCC from vaccination is likely even higher, as these estimates do not account for prevention of SARS-CoV-2 infection by vaccination," the study authors wrote.
Yet pediatric COVID-19 vaccination rates are low, with only 12% of children ages 5 to 17 years current with the recommended doses as of December 2024. "Surveys have shown that one reason behind parental COVID-19 vaccine hesitancy is the idea that COVID-19 in children is usually a mild illness and therefore vaccination is not necessary," the researchers wrote. "However, even mild or asymptomatic SARS-CoV-2 infection can result in postinfectious sequelae."

The Centers for Disease Control and Prevention (CDC) said on Monday that the new coronavirus found in bats is currently not a cause for concern.

There is no reason to believe the virus poses a threat to public health at the moment and no infections have been detected in humans, according to the federal health agency.

"CDC is aware of a publication about a new bat coronavirus, but there is no reason to believe it currently poses a concern to public health," the agency said in a statement. "The publication referenced demonstrates that the bat virus can use a human protein to enter cells in the laboratory, but they have not detected infections in humans."

Chinese researchers, including from the Wuhan Institute of Virology and Guangzhou Medical University, published a paper in the journal Cell on Friday indicating they had discovered a new bat coronavirus that could have the potential to infect humans.

The newer coronavirus is known as HKU5-CoV-2 and is a type of merbecovirus, which is the same family of another coronavirus known to infect humans called Middle East Respiratory Syndrome (MERS).

In a lab study, the new coronavirus was found to have the potential to enter cells through the ACE2 receptor, a protein found on the cells' surface.

This is the same way the virus that causes COVID-19 infects people, which theoretically means the new coronavirus could pose a risk to spilling over into humans.

The spike protein of the new coronavirus infected human cells that had high levels of the ACE2 receptor in test tubes, as well as in small models of human airways and intestines.

The researchers found that the virus did not enter human cells as readily as the virus that causes COVID-19 -- which is called SARS-CoV-2 -- writing that the "risk of emergence in human populations should not be exaggerated."

None of the animal studies that were conducted examined the virus's ability to cause disease or its transmissibility.

If the virus were to infect humans, the researchers suggested antiviral drugs and monoclonal antibodies -- laboratory-produced proteins that mimic the antibodies the body naturally creates when fighting a virus -- could be effective.

There are hundreds of coronaviruses circulating in nature. Only a few can infect humans, causing illnesses ranging from mild respiratory tract infections to more severe conditions such as bronchitis or pneumonia.

Coronaviruses include some variations of the common cold, the virus that causes MERS, severe acute respiratory syndrome (SARS) and the virus that causes COVID-19.

It’s been five years, and more than 20 million deaths globally. The first official case was in December 2019. The World Health Organization designated Covid-19 a public health emergency at the end of January 2020, the U.S. government declared it a national emergency on March 13, and every single state ordered or recommended schools close at some point between March 16 and March 27. What followed was trauma: years of mass mortality, inescapable infection and deep disruption, even to the lives of the relatively safe.

My first hint came via Twitter on Dec. 31, 2019, when I saw the health and medicine journalist Helen Branswell warning of “unexplained pneumonias” in China. The plot beats that would follow were, in certain ways, familiar enough, Hollywood and science fiction having taught us all about global health emergencies and what might be done to stop them. But although I could easily imagine a pandemic unfolding onscreen, I couldn’t really believe we’d end up living through one, so deep were my intuitions that plagues were — at least in the wealthy world — a thing of the past. Whatever I’d heard from scientists about the risks of this or that future outbreak, I was living firmly in epidemiological denial.

Two months later, in the first days of March, I found myself having dinner with an old friend who told me that he and his father had recently made a casual bet about how many Americans would ultimately die of the disease. His father had bet the total would be under 100,000; my friend had guessed more. “What do you think?” he asked me. I grimaced a little. “I’d take the over at a million,” I said.

I was reminded of this all recently when reading about a similar bet that the writer and podcaster Sam Harris said he made with his former friend Elon Musk at the beginning of the pandemic. (It’s ugly but perhaps illuminating to realize how many responded to the scary news by gambling on it.) Musk’s intuition was that the whole thing would just go away. On March 19, 2020, he tweeted that “on current trends,” the country was headed to no new cases sometime by the end of April, and he bet Harris that the outbreak would produce fewer than 35,000 cases in total. When the official count of Covid deaths passed 35,000 in April, Harris wrote to Musk to ask, cheekily, whether this meant he’d won the bet. Musk did not respond. In fact, to read Harris’s retelling of it, that was the end of their friendship and the moment he watched his old comrade disappear into a kind of alternate reality.

Today, the official Covid death toll in the United States stands at 1.22 million. Excess mortality counts, which compare the total number of all-cause deaths to a projection of what they would have been without the pandemic, run a little higher — about 1.5 million.

In other words, the alarmists were closer to the truth than anyone else. That includes Anthony Fauci, who in March 2020 predicted 100,000 to 200,000 American deaths and was called hysterical for it. The same was true of the British scientist Neil Ferguson, whose Imperial College model suggested that the disease might ultimately infect more than 80 percent of Americans and kill 2.2 million of us. Thankfully, the country was vaccinated en masse long before 80 percent were infected, but as early as March 2020 Donald Trump and Deborah Birx (who helped run the White House’s Covid response) appeared to be referencing Ferguson’s figure to claim credit for avoiding more than two million deaths — a success they explicitly attributed to shelter-in-place guidelines, business closings and travel restrictions.

Five years later, though the world has been scarred by all that death and illness, it is considered hysterical to narrate the history of the pandemic by focusing on it. Covid minimizers and vaccine skeptics now run the country’s health agencies, but the backlash isn’t just on the right. Many states have tied the hands of public health authorities in dealing with future pandemic threats, and mask bans have been implemented in states as blue as New York. Everyone has a gripe with how the pandemic was handled, and many of them are legitimate. But our memories are so warped by denial, suppression and sublimation that Covid revisionism no longer even qualifies as news. When I come across an exchange like this one from last weekend, in which Woody Harrelson called Fauci evil on Joe Rogan’s show, or this one from last year, in which Rogan and Tony Hinchcliffe casually attribute a rise in excess and all-cause mortality to the aftereffects of vaccination, I don’t even really flinch.

To be clear, their suggestion is spurious. (Ironically, the vaccines are the reason we can even entertain such speculation.) In some countries where vaccination was more universal than here, such as the U.K., shots effectively brought an end to the pandemic emergency. And as I wrote two years ago, total mortality through the pandemic has tracked so closely with known Covid waves — spiking when cases were also spiking, subsiding when the disease was also in retreat — it was disingenuous to pretend the “unexplained” death was driven primarily by something other than the disease itself. American contrarians have often pointed to Sweden to suggest a lighter-touch alternative was possible, but even the architect of that policy, who owes his global stature to the story of Swedish exceptionalism, has spent the five-year anniversary emphasizing, among other lessons, how similar his country’s approach was to the rest of the world.

The pandemic response wasn’t perfect. But the pandemic itself was real, and punishing. Above all, it revealed our vulnerability — biological, social and political. And in the aftermath of the emergency, Americans have largely looked away, choosing to see the experience less in terms of death and illness than in terms of social hysteria and even public health overreach. For many, the main lesson was that in the world of humans, as in the world of microbes, it’s dog-eat-dog out there.

But the consequences and aftershocks were also more subtle and diffuse: it isn’t easy to live in isolation and in fear, often largely online and surrounded by exceptional illness and mortality, as we watched aspects of the world and our own lives we’d long taken for granted be withdrawn or torn apart. And it isn’t easy to get over all that, however eager we thought we were to “return to normal.” We lived through as many deaths as some of the worst-case scenarios predicted, and without an initial spasm of inspiring solidarity and miraculous biomedical intervention, it could have been worse. But when we came out the other side — 1.5 million fewer of us — we were, as a country, exhausted, resentful, deluded and distrustful.

During the five-plus years that COVID has existed, our conception of the virus that causes it has been a slippery thing. It has been a terrifying mystery and a daily reality, a killer pathogen and “just the flu,” an alphabet of variants that burst on the scene only to disappear from public consciousness.

Amid all this morphing, what has stayed constant is that COVID has been, in one way or another, wearying in a bone-deep way. It was tiring to disinfect surfaces and then to learn that the virus was in fact airborne. It was tiring to scramble for toilet paper, for masks, for vaccines. It was tiring to fear an invisible virus and to stay away from other people. And it has been tiring to return to society—whether with abandon, fear or something in between.

Regardless of how each of us has responded to the virus’s threats, its shadow has haunted our lives for five years in ways we never even thought to imagine before we encountered the then novel coronavirus SARS-CoV-2. “I think we’re all exhausted, and we’re not actually admitting it,” says Alexandre White, a sociologist and historian of medicine at Johns Hopkins University. That’s a problem, he says. “There’s real power in mourning and real power in memorial,” White says. “I think we’ve too easily moved on from COVID in such a way that we assume that since we all lived through it, there’s nothing really more to talk about, and I think that there’s a lot more to talk about.”

Discussing how each of us experienced the past five years and its many stressors—and listening to others do the same—could be a way to heal the rifts that COVID has left in U.S. society.

THE PANDEMIC’S TOLL
Not long after COVID hit the U.S. in earnest, the phrase “quarantine fatigue” had come into use. As the days turned to months, the language morphed into “pandemic fatigue.” But the fatigue itself has had countless sources over the years, and the term has often encompassed many more emotions than simply fatigue, including loneliness, sadness, anger, fear and boredom.

Each person’s experience was influenced by a host of factors. The most severe one, of course, has been death—so much death. In 2020 COVID killed or contributed to the deaths of at least 385,000 people in the U.S. And in 2021 the number was more than 463,000, according to the Centers for Disease Control and Prevention. Losing family members early, without proper deathbed visits or funerals, brought a particular type of pain. And while their rate has declined, the deaths have continued. As of March 6, the five-year death toll was 1,225,281 people. Even now, the tally grows by hundreds every week.

Those of us who have so far escaped COVID without it stealing loved ones have nonetheless faced grief, stress and fear, particularly during the early weeks and months of the pandemic, that were unthinkable to many Americans in 2019.

Medical professionals suffered high rates of burnout and moral injury. The people classified as essential workers—grocery cashiers and farm workers, delivery drivers and electricians—found themselves suddenly risking their lives for their jobs. Children abruptly had to learn from a screen, while working parents, particularly mothers, attempted to simultaneously oversee a makeshift classroom. Proms and holiday gatherings, happy hours and vacations were all canceled.

In October 2024 half of U.S. adults surveyed about their experience said that COVID took a minor toll on their lives; another quarter say it took a major one. Thirty percent overall said they had experienced a toll that they had not or only somewhat recovered from.

It’s not surprising that COVID’s acute stages took a toll in the U.S.—or that the recovery has been difficult here. The country was out of practice when it came to dealing with pandemics. Many of the disease scares of recent decades—SARS, MERS, Ebola, Zika—in large part spared the U.S. Even the swine flu of 2009, which killed 12,500 people in the country within its first year, fizzled out in less than two years. The spread of HIV/AIDS has been devastating, but its transmission routes have allowed many Americans to feel isolated from its threats. The previous most severe respiratory epidemic the U.S. faced was the influenza pandemic of 1918, a full century before COVID.

The 1918 pandemic was very different from the rise of COVID in 2020, says Nancy Tomes, a historian at Stony Brook University. In the U.S. the bulk of influenza infections occurred during just a couple of months in the fall of 1918 and while the nation was at war.

People were used to devastating infectious diseases in the early 20th century—still, the U.S. public struggled with pandemic restrictions. “Even at a time when the majority of Americans had experience with deadly infectious diseases and were much easier to scare, they had trouble changing their behavior to prevent the spread of something fast-moving,” she says.

Since then scientists and doctors have had some success in taming germs, thanks to the twin wonders of vaccines and treatments, Tomes says. “Americans had started to expect that there’s a drug for everything and a vaccine for everything”—and that “if there is a dangerous new disease and there isn’t an immediate cure or vaccine for it, somebody has done something wrong,” she says.

THE MANY FLAVORS OF PANDEMIC FATIGUE
When COVID first hit, many people leaned into their communities, making sacrifices in attempts to protect neighbors and loved ones. But as time went on, communal thinking seemed to fray in the face of clear challenges. Solidarity disintegrated as a host of factors lumped into a diagnosis of “pandemic fatigue” took root.

Scientists scrambled to understand COVID and the virus that caused it—with some remarkable success. But to everyday people living in fear, the process was a far cry from the grade-school vision of how settled science works. “This was a lot more uncertain,” says Richard Carpiano, a public health scientist and sociologist at the University of California, Riverside. “What the public really got out of this was a front-row seat to watching science unfold.”

Early in the pandemic, some people who survived COVID didn’t fully recover. These “long haulers,” as they were soon dubbed, fought against medical systems that didn’t expect the new virus to trigger an array of disabling long-term conditions that came to be known as long COVID. Today people with this condition are learning how limited support for people with such disabilities can be in the U.S.

Unsurprisingly, COVID hit society’s least-privileged members hardest: people of color, low-income people and the elderly. “Inequality haunts every epidemic,” White says. “Epidemics can cause inequities in a society, but more often than not, they prey very effectively on the existing inequities within the population.”

Pandemic action plans failed to account for opposition to safety measures, including school closures, mask mandates and vaccination, says Andrew Lakoff, a medical anthropologist at the University of Southern California. Political actors seized on this dissent to drive people apart. “We were suffering from anxiety and a lot of people getting sick and dying, and the social fabric was getting torn apart,” he says.

Despite the virus’s novelty, scientists produced effective vaccines against it on a miraculously short time line, deploying them within a year after infections began. But existing antivaccine efforts that focused on childhood vaccines and targeted mainly parents also moved fast, latching on to the new vaccines. “The COVID vaccine that the whole population had to take diffused a lot of the antivaccine discourse into the general public,” Carpiano says.

Throughout it all, medical professionals who had risked their lives from the beginning found themselves not only still facing a constant onslaught of patients but now also trying to squash misinformation and denial about the disease.

As these threats built and COVID continued to bulldoze its way across the U.S, people moved away from collective care for one another’s health. COVID shots became an annual ritual for some, but only one in every four or five adults in the U.S. now gets the vaccine. Only 4 percent of U.S. adults report regularly wearing a mask, which reduces transmission of not only COVID but also colds, the flu and other respiratory infections. “COVID was a radical test of collective unity, and America deeply unveiled its individualism and lack of collective heart,” says Emily Mendenhall, a medical anthropologist at Georgetown University.

COVID’S CONTINUING IMPACT
Whatever the source of fatigue, the U.S. public generally was eager for the COVID pandemic to end. “Pandemics end when a sizable proportion of the population feels that they’re not at risk from the disease anymore,” White says. This occurs regardless of how accurate the assessment is or how poorly it applies to the rest of the population. “There’s a certain luxury in claiming a pandemic’s ending,” he says.

In March 2025 it’s easy to feel the world is just as chaotic as it was five years ago—or worse. “I think people are sick of talking about COVID, and I don’t think it’s because people don't care,” Mendenhall says. “I think it’s just because there are so many more pressing issues right now.”

The pandemic pushed U.S. society past its limits in ways that continue to reveal themselves. Donald Trump is president again, politics are more divisive than ever, and bird flu threatens to become the next human pandemic, even as the president is axing science and social safety nets.

The timing may not be a coincidence, given how the pandemic made people reevaluate their relationship with the government and the role they want it to play in their lives. “While a virus was invading people’s bodies, it also really crept into these fault lines of our society and our culture,” Carpiano says. “It makes us think about our social contract with our government in terms of what it means to provide for our well-being and for our safety.”

None of these trends bodes well for the U.S.’s ability to effectively respond to the next public health crisis—whether it’s avian influenza or something else. White sees a sharp contrast with the 1918 pandemic: by its end, no one wanted to talk about it, but its memory helped inspire the creation of the World Health Organization and other antipandemic measures. Today it’s primarily community organizers and long COVID activists, as well as public health experts, who are leading efforts to turn the painful experience of COVID into something that can help prepare us for future disease threats.

“Pandemic preparedness is not a last-ditch solution; it’s really a constant set of strategies for monitoring such threats,” White says. “I’m concerned today with pandemic defeatism—where rather than maintain systems prepared for another pandemic or continue combating COVID-19, we might be too quickly choosing to ignore the very real risks that are out there and instead throw up our hands, suggesting that there’s perhaps nothing we can do.”

In our exhaustion, that strategy may sound appealing. But it risks even more dire consequences than the ones COVID has brought. “That would be such an incomprehensible tragedy,” White says. “We can do better—and we have to do better, for each other.”

Although the WHO declared an end to the COVID public health emergency in May 2023, the organization has emphasized that the pandemic isn’t over—it’s just entered an endemic phase, which means that the virus will continue to circulate indefinitely. Throughout the past four years, Maria Van Kerkhove, now interim director of the WHO’s Department of Epidemic and Pandemic Preparedness and Prevention, has helped lead the agency’s response to COVID. Scientific American spoke with Van Kerkhove about entering the fifth year of a pandemic that many want to ignore despite its permanent impact on lives around the world.

How would you describe the overall state of COVID at this point in the pandemic?
COVID’s not in the news every day, but it’s still a global health risk. If we look at wastewater estimates, the actual circulation [of SARS-CoV-2] is somewhere between two and 20 times higher than what’s actually being reported by countries. The virus is rampant. We’re still in a pandemic. There’s a lot of complacency at the individual level, and more concerning to me is that at the government level.

Lack of access to lifesaving tools such as diagnostics, therapeutics and vaccines is still a problem. Demand for vaccination is very low around the world. The misinformation and disinformation that’s out there is hampering the ability to mount an effective response. So we feel there’s a lot more work to do, in the context of everything else—[we no longer have a] COVID lens only, of course, but using masks for respiratory pathogens that transmit through the air is a no-brainer—plus vaccination, plus distancing, plus improving ventilation. People are living their life; we’re not trying to stop anyone from doing anything, but we’re trying to work with governments to make sure they do that as safely as possible.

We don’t know everything about this virus. Even in year five, there’s still a lot of research that needs to be done.

What’s it like emotionally to be so deep in trying to understand and respond to the pandemic?
It’s pretty incredible. I mean, I can’t believe we’re entering year five of COVID.

There are some massive mental health impacts, globally, that we’re not dealing with. I’m dealing with my own, which I’m only now starting to reflect upon. I didn’t give it a chance—I didn’t have the opportunity to give time to it—but now I’m actually taking some time because this is not normal. The COVID pandemic was not normal. This amount of death is not normal. It didn’t have to be this way.

Instead of “What should we have done differently?” I say, “What can we do differently today?” I feel so determined to really keep this marathon up. Maybe it’s not in the news, but our work hasn’t stopped. It’s heavy, I would say. It’s a lot, and I don’t want to sugarcoat it.

Do you have advice for people looking to strike that balance between taking preventative measures but also living their life, particularly amid governmental complacency?
We’re asking you to stay home if you’re unwell but also seek medical care if you need to seek medical care. Get tested so that you can get the right treatment course. Wear masks when you’re in crowded places. If you’re going to be around older people, test yourself before you go; use a self-test—things such as that.

But that’s not enough. Governments need to provide tests, and those tests need to be available either at a reduced cost or free. Masks need to be available. If I say, “Get a test,” where are you going to get one? Can you afford one? If I say, “Make sure you get treatment,” where are you going to get that?

It’s not enough for me to tell individuals [these things]. What I tell my own family, what I say publicly, is “Take measures every day as a precaution.” But it’s also our work as WHO to work with governments to ensure that they keep up the surveillance [of viral threats], that they keep up good communication, that they provide treatments, that they provide tests, that they provide vaccines and that they improve ventilation.

So it’s a two-sided coin, what we want individuals to do and what we want governments to do.

Do you have any predictions for COVID in the coming year?
We don’t do predictions—what we do is we plan for scenarios. Our concern is a variant that’s highly transmissible, that is more severe and that has significant immune escape, which [would mean that people would] really need to get revaccinated right away. And that’s one of the scenarios that we plan for, which is why systems have to be in place that you can scale up or scale down.

And of course, the worry is complacency. The worry is reduced fiscal space, mental space and political space to talk about COVID in the context of everything else. I am not suggesting that the world drop what it’s doing and focus [only] on COVID. That is not what WHO is suggesting. We’re saying, “Please don’t drop the ball.” The virus is here. It’s evolving. it’s killing. It’s causing post-COVID conditions [also called long COVID]. And we don’t know the long-term effects. It’s a virus that is here to stay.

I read that half the global population has a major election this year. How does that play into the COVID landscape?
It’s always an election year. Absolutely elections play a role because [there’s a risk of] outbreaks, and certainly COVID has been politicized. This has been a major factor in the past four years. But pandemics outlive any election cycle.

All of the COVID interventions have been politicized and with huge amounts of misinformation and disinformation that spreads faster than viruses. And misinformation, disinformation and politicization kill.

Are there any other things you’d like people to know about COVID right now?
I think it’s important that we continue to talk about it. We understand you don’t want to hear about it. I don’t want to talk about it. But we need to because there’s more we can do. We cannot prevent all infections. We cannot prevent all deaths. But there’s a hell of a lot more that we can do to really keep people safe and save them from losing a loved one.

In May 2023, the World Health Organization (WHO) declared the COVID-19 global health emergency over.

Yet millions of people still experience fatigue, breathlessness and pain, years after having a COVID-19 infection. By some estimates, 400 million people had or still have post-COVID-19 syndrome, a condition better known as 'long COVID'.

Scientists have struggled to find the causes of long COVID since the first cases of chronic symptoms emerged in late 2020. Clinicians still lack the tools to treat the disease.

Now, a new study published in the journal Science has discovered lung inflammation is a major cause. Data in mice and humans found infection with the SARS-CoV-2 virus, which causes COVID-19, impairs the ability of immune cells to repair lung damage.

The study gives hope in treating long COVID, although further testing is required for the treatment to reach clinics.

"We demonstrated that an FDA-approved drug can enhance lung recovery and reduce long COVID-related tissue damage," said study lead author Jie Sun, an immunologist at the University of Virginia, US?

COVID-19 impairs lung regeneration
"Long COVID presents a wide range of symptoms, and its underlying cellular and molecular mechanisms are highly complex," said Sun.

"One of the most significant gaps is identifying the specific mechanisms driving different types of long COVID. Understanding these drivers is crucial for developing targeted therapeutic strategies."

In searching for a true driver of long COVID, Sun and his collaborators analyzed lung samples from people with long COVID and mice given the disease.

"We discovered that lung tissue from individuals who succumbed to acute COVID or suffered from severe respiratory long COVID exhibited decreased levels of peroxisomes in a type of immune cell responsible for tissue healing," said Sun.

Peroxisomes are tiny organelles inside immune cells. They are detox centers that remove toxic molecules and help tissues to heal after being damaged.

The study found peroxisomes play a crucial role in the rapid regeneration of damaged lung tissue.

"This research suggests that SARS-CoV-2 leads to dysfunctional peroxisomes. This, in turn, leads to impaired healing and scarring after infection – leading to long-term symptoms," said Ziyad Al-Aly, a senior clinical epidemiologist and long COVID researcher at Washington University in St. Louis, US.

Potential long COVID treatment needs further testing
The researchers looked for existing drugs that could reverse the lung damage caused by a COVID-19 infection and focused on drugs that boost the function of peroxisomes — which they hoped would improve lung repair.

Treating COVID-19 infected with a drug called sodium 4-phenylbutyrate (4-PBA) led to increased peroxisomes and reduced lung scarring. The researchers said this provides evidence the drug could help treat people with prolonged lung damage due to long COVID.

"Given the significant number of affected individuals, this represents a promising therapeutic avenue," said Sun.

The benefit of 4-PBA is it is already approved by drug regulators like the US Food and Drug Administration (FDA) to treat urea cycle disorders. This means it has already been deemed safe to use as a treatment in humans, which could accelerate clinical trials testing it for long COVID.

However, Al-Aly, who was not involved in the study, warned findings in mice do not always translate to humans.

"Whether this works in mild COVID and whether it works in humans is not known. There is a clear need to evaluate this in humans," he said.

Long COVID has many causes
Sun said their discovery of lung inflammation as a driver of long COVID is important but acknowledged there are other changes in the body after a COVID-19 infection that can cause long COVID.

"Long COVID is a highly heterogeneous condition, and different subtypes may involve distinct underlying mechanisms," Sun said.

Some of those drivers include viral reservoirs that continuously stimulate the immune system, microbiome imbalances, reactivation of latent viruses, and blood clotting abnormalities.

These mechanisms might all be interacting to cause long COVID symptoms. It means one of the drivers is treated, it might be able to stop long COVID.

Al-Aly said the study is part of a mobilization of scientists making significant progress on long COVID in the last five years.

This research is critical, he said, as millions of people with long COVID are not experiencing full recovery and are still struggling with symptoms.

Seven Americans may have contracted COVID-19 in Wuhan in October 2019, several months before the reported start of the pandemic, according to a bombshell military report obtained by the Washington Free Beacon that the Biden administration concealed from the public.

The December 2022 report, which the Biden administration was required by law to release to the public over two years ago but didn’t, reveals for the first time that seven U.S. military service members contracted COVID-19-like symptoms during or after their participation in the World Military Games in Wuhan in October 2019—contradicting the Biden administration’s public claims in 2021 that there was no evidence that any American participants contracted the virus at those games. The revelation adds to a mounting body of evidence that the virus was circulating in Wuhan for months before China disclosed it to the world in December 2019 and further bolsters the growing consensus that it could have leaked into the human population from a Chinese lab.

The 2022 National Defense Authorization Act required the Biden administration to make its report on the 2019 Wuhan World Military Games "publicly available on an internet website in a searchable format" by the summer of 2022. Though the Biden administration transmitted copies of the two-page report to the House and Senate Armed Services Committees in December 2022, it didn’t see the light of day until sometime in late March when the Trump administration quietly uploaded it to a Defense Department website.

The potential COVID-19 illnesses from the American participants in the Wuhan World Military Games appear to have been a closely guarded secret of the Defense Department. Chinese authorities have suggested since as early as February 2020 that America could have unleashed COVID-19 into Wuhan through their participation in the World Military Games. Former Biden Defense Department spokesman John Kirby told the Washington Post in June 2021 that the military had "no knowledge" of any COVID-19 infections among the troops that participated in those games.

The first Trump administration issued similar statements regarding the Wuhan games. In June 2020, the Pentagon told the Prospect that it did not test any of the American troops that participated in the games because they were held "prior to the reported outbreak."

The games were held within close proximity of the Wuhan Institute of Virology, where Chinese scientists, backed by U.S. taxpayer funds, conducted risky gain-of-function research on the same sort of bat coronaviruses that caused the pandemic. That research, which was supported by former National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci, "almost certainly caused COVID-19," Rutgers University professor of chemical biology Richard Ebright told the Free Beacon.

The American military athletes traveled to and from Wuhan via Seattle-Tacoma International Airport, according to the Prospect, which noted that Washington was one of the earliest COVID-19 hotspots in the country.

The report speculated that other respiratory infections could have caused the COVID-like symptoms exhibited by the seven service members and that there was no "statistically significant difference" in COVID-like cases at the military bases those soldiers were stationed at compared to those without them. The seven soldiers all recovered from their symptoms within six days.

The Pentagon did not disclose when it discovered the potential illnesses. The Pentagon declined to comment

Knowledge that U.S. troops may have contracted COVID-19 in Wuhan during the October 2019 games may have been well received by U.S. allies. Military athletes from Germany, France, Italy, and Luxembourg who competed in the October 2019 games also reported coming down with COVID-19-like symptoms during their stay in Wuhan, which they described as a "ghost town," the Daily Mail reported.

Ebright, one of the most prominent academic proponents of the theory that COVID-19 leaked from the Wuhan Institute of Virology, said he was appalled that the Biden administration concealed crucial information about the first potential American cases of the virus from the public amid the ongoing debate over the pandemic’s origins.

"It is an outrage that the Biden White House and the 118th Congress Senate and House Armed Services Committees did not publicly release this information when it became available in 2022, but, instead, withheld this information for the duration of their terms," Ebright told the Free Beacon.

"This new information strengthens U.S. and allied intelligence data indicating that COVID-19 was circulating in Wuhan in October-November 2019, U.S. and allied intelligence data indicating that researchers working with genetically enhanced SARS viruses at Wuhan Institute of Virology contracted COVID-19 in October-November 2019, and phylogenomic data indicating that the virus that causes COVID-19 entered humans in July-November 2019."

Ebright’s sentiment was shared by Sen. Joni Ernst (R., Iowa), who said the report’s findings discredit the theory that COVID-19 originated from a Wuhan wet market in December 2019.

"Taxpayers deserve to know the truth about COVID-19 origins, but the Biden administration concealed this information from the American people for years," Ernst told the Free Beacon. "This report should have been made public immediately and not restricted to Washington insiders. If Americans visiting Wuhan were potentially infected with the COVID-19 virus in October 2019, those claiming the pandemic began in a wet market just two months later would be completely off base."

Five years after COVID-19 hit, a majority of New Yorkers say they feel more isolated than ever, according to a poll released Wednesday.

The Siena College poll found also 43% of those surveyed try to act as if the pandemic never happened and try never to talk about it.

Those were numbers higher than expected and reflects a "collective trauma" that probably still is ongoing, Siena pollster Don Levy told Newsday in an interview Tuesday.

"I was surprised by that — that it was so high," Levy said about so many New Yorkers expressing feelings about still feeling isolated. "I did not believe we would see 51% and I did not believe we would see it so high (63%) with young people."

It was one of many results Siena found in a survey taking the pulse of the state five years after the worldwide pandemic began.

Collectively, New Yorkers expressed lingering anger (57%) about the pandemic and a lack of confidence in the federal government (50%-45%) to handle another health emergency. Most (67%) knew someone who had died and almost half (45%) said they experienced financial hardship during the pandemic.

Conversely, two-thirds say a silver lining from the pandemic was that it helped them focus more on family and friends, and a plurality (48%) said they found a better work-life balance.

Levy said responses to the isolation question particularly were striking and could be linked to other impacts highlighted in the survey.

In the survey, 51% overall said they agreed or strongly agreed with the statement: "COVID resulted in me feeling more isolated and alone than I have ever felt before."

About 46% disagreed with the statement.

Among New Yorkers 18 to 34 years old, 63% said they felt isolated and alone.

"This was a collective trauma that we all went through and each of us went through it differently," Levy said. "To get to a point where half are saying they feel more isolated and lonely than ever, it is truly an expression of collective trauma that goes through to today. This one question in the survey is one indication it may have changed us."

The New York response is perhaps a reflection of national surveys that have found an association between COVID isolation and depression.

And though it wasn’t a majority, 43% told Siena they agreed with the statement: "To be honest, I no longer want to talk about or think about COVID. I try to act like it never happened."

About 51% didn’t agree with that statement.

"I don’t think life is back to the same," Levy said. "It changed us in ways that we don’t completely understand yet."

Yet, on what might be called a "bright side," 41% said they started a new hobby during the pandemic, 32% started some type of self-improvement program and 20% acquired a new pet — which Levy is "a lotta people." He called the "phenomenon" understandable.

"If you suddenly were working from dining room and not going out and wearing a mask and not having normal interactions," Levy said, "they went out and bought a Peloton (exercise bike) and a shih tzu."

Clinical psychologist Christopher Fisher, who has a practice in Rockville Centre and is director of behavioral health at Northwell Health, said: "It’s actually surprising that only 51% of people reported feeling more isolated. Frankly, I expected that number to be higher. In 2020, the world was forced to drastically shift how we live and interact. While this disruption was both a challenge and a catalyst for innovation, it reshaped the very systems we rely on.

"Remote work, asynchronous learning and physical distancing were quickly normalized as tools to help us meet our responsibilities while staying safe. However, these systems also made it easier, and in some cases more comfortable, to remain distant from others," Fisher said.

"Just as it was difficult to adapt at the onset of the pandemic, it will be just as challenging to re-engage and reconnect in its aftermath," he added.

The Food and Drug Administration is planning major changes for how Covid vaccines are rolled out and who will be able to get the updated shots this fall.

In a paper published Tuesday in the New England Journal of Medicine, FDA Commissioner Dr. Marty Makary and Dr. Vinay Prasad, the FDA’s new vaccine chief, wrote that any new Covid vaccine now must undergo placebo-controlled clinical trials — meaning, some people would get the actual vaccine while others get an inactive substance like a saline shot, to compare results.

At a planned FDA vaccine panel meeting on Thursday, agency advisor are expected to advise the vaccine makers which strains to target for new shots. The new clinical trial requirement isn't expected to affect the fall rollout for older adults and other people at high risk for severe illness because drugmakers are exempt from additional testing for those groups.

Makary and Prasad said in a question and answer session later Tuesday that annual shots for healthy children and adults would no longer be routinely approved. They also suggested that the vaccines may not be updated each year.

”Instead of having a Covid strategy that’s year to year, why don’t we let the science tell us when we should change?” Prasad said. “The virus doesn’t have a calendar.”

Previously, updated Covid vaccines had been cleared by the FDA similar to flu vaccines.

The original Covid shots, from Pfizer and Moderna, approved in late 2020, went through placebo-controlled trials. Then, the drugmakers transitioned to smaller studies to test how well the updated shots triggered an immune response against the current variants circulating in the U.S.

In the journal article, Makary and Prasad cast doubt on the flu vaccine model, noting that only a quarter of people in the U.S. get the updated shots each year, including less than a third of health care workers.

In comparison, about 75% of health care workers get seasonal flu shots, according to data from the Centers for Disease Control and Prevention.

The Covid shot policy, the officials wrote, “has sometimes been justified by arguing that the American people are not sophisticated enough to understand age- and risk-based recommendations.”

“We reject this view,” they added.

Dr. Jesse Goodman, a professor of medicine and infectious disease at Georgetown University and a former chief scientist at the FDA, agreed that people can understand their own health risks, but was skeptical of the agency’s new approach, saying it limits people’s “freedom to choose.”

“What about people with elderly or high risk relatives/housemates?,” he wrote in an email. “What about people who are not at increased risk of severe disease who want to reduce their risk of infection or time off from work?,” Goodman asked.

During the webcast, Prasad claimed “there is no high quality evidence that you getting a booster to visit your grandma protects your grandma.”

Who will be able to get the Covid shots?
Under the FDA’s new guidance, the drugmakers will need to run new trials that track participants for at least six months.

The main goal of the trials should be showing that the shots help prevent symptomatic Covid, the officials wrote, with data showing at least 30% effectiveness. People who’ve had Covid in the past should still be included in the trial to better reflect the general population, they said.

Drugmakers can still use smaller studies, known as immunogenicity studies, to get approval for adults 65 and up, as well as children and adults with at least one medical condition that puts them at higher risk for Covid.

The FDA said many people are considered at high risk, including pregnant women and those with obesity or who have mental health conditions such as depression. Other conditions linked to severe Covid illness include diabetes, heart disease and asthma.

“Ultimately, these studies alone can provide reassurance that the American repeat-boosters-in-perpetuity strategy is evidence-based,” the officials wrote.

Estimates, they said, suggest that 100 million to 200 million Americans will have access to the updated vaccines.

The FDA’s mandate comes ahead of Thursday’s vaccine advisory committee meeting, where outside experts will discuss which strains should be included in the next round of Covid shots.

In briefing documents published earlier Tuesday, FDA staff wrote that updating the vaccines to more closely match currently circulating strains may “provide added benefit” in anticipation of an uptick in cases during the fall and winter.

The change means it will be near impossible for Pfizer and Moderna to complete the new trials in time for the fall season. Aside from running the trials, the drugmakers will still need to design the trials and enroll participants, which can also take several weeks or months.

The data would then need to be analyzed and signed off by the FDA. It’s also unclear what the change will mean for healthy children and adults who want to get the updated shots.

Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia and a member of the FDA’s vaccine advisory committee, said people considered at “low risk” can still be harmed by the virus.

Low risk doesn’t mean no risk,” he said. “I mean anybody can be hospitalized and killed by the virus.”

Goodman questioned why the FDA was making the change instead of the CDC’s independent vaccine advisory committee, known as Advisory Committee on Immunization Practices, which typically makes recommendations on who should get the Covid shots.

“It is not clear why there was a compelling reason for FDA to step in and preempt that usual and publicly transparent consultative process,” he said.

Kennedy's influence on vaccine rules
A change to the way Covid vaccines are updated was expected. Earlier this month, Health and Human Services Secretary Robert F. Kennedy Jr. mandated that all new vaccines must undergo placebo-controlled clinical trials.

Until Tuesday, it wasn’t clear whether HHS considered Pfizer’s and Moderna’s updated shots “new vaccines,” requiring new clinical trials.

Former government health officials feared that the FDA, under Kennedy, was moving to slow-walk vaccine approvals.

Over the weekend, the FDA approved Novovax’s vaccine after weeks of delay. In an unexpected turn, however, the agency limited the use of the shot to people 65 and up and teens and adults with at least one medical condition that puts them at risk of severe illness. Typically, it’s the CDC that makes recommendations about who should get the vaccines.

Makary had warned about changes to the way vaccines are tested and approved, saying last week that the agency would soon “unleash a massive framework.”

Kennedy isn’t the only health official who has been critical of the Covid vaccines. Makary, Prasad, Dr. Tracy Beth Hoeg, a special advisor to Makary, and Dr. Jay Bhattacharya, the head of the National Institutes of Health, have as well.

The Food and Drug Administration said late Thursday it would like drugmakers to update the Covid vaccines to target the LP.8.1 strain, fueling concerns that the shots may be limited to only the most at-risk Americans this fall.

The FDA’s decision differs slightly from the recommendation made by its vaccine advisory committee earlier that day, which was to stick to the strains used in the current Covid shots, although panel members said LP.8.1 was a suitable alternative.

Studies by Moderna and Pfizer showed that an LP.8.1-targeted vaccine in fact induced a modestly stronger immune response to the circulating strains than the current Covid shots, which target a variant called JN.1 or one of its descendants, KP.2.

LP.8.1 is also a descendent of JN.1, and it is the dominant strain circulating in the U.S., accounting for roughly 3 in 4 new Covid cases, according to FDA briefing documents released earlier this week. It’s different from a strain dubbed NB.1.8.1 that was recently detected in the U.S. and caused a surge in hospitalizations in China.

Normally, changing the strain for the vaccine wouldn’t raise questions — it's been the practice of the U.S. in recent years, following a similar model to how the flu shot is updated each year. For Pfizer and Moderna, their mRNA technology makes it particularly easy to update their vaccines.

But this year, the change is expected to trigger new rules by the FDA that new Covid vaccines for healthy kids and adults must undergo placebo-controlled clinical trials — a process Dr. Marty Makary, the agency’s commissioner, told a Senate committee on Thursday could take roughly a year.

The updated Covid shots are still expected to be available in the fall to adults 65 and up and kids and adults with at least one medical condition that puts them at risk for severe illness — two groups that are exempt from the clinical trial requirement.

The list of underlying conditions that raises a person's risk is extensive — “physical inactivity” is even included. Officials estimated that more than 100 million people in the U.S. would still qualify for a shot.

But the clinical trial requirement “would clearly delay and impede access to vaccines for those people who want it,” said Dr. Jesse Goodman, a professor of medicine and infectious disease at Georgetown University and a former chief scientist at the FDA.

However, Goodman added, a number of questions remain about the FDA’s policy, including how many people would be needed for the trials and whether a new strain selection would indeed trigger the new trial requirement.

When asked by committee members about the new policy on Thursday, FDA officials either said that the questions were off-topic or that the agency was still finalizing the details with drugmakers.

The FDA’s notice also states it would “preferentially” like drugmakers to update their shots to the LP.8.1 strain — potentially leaving room for drugmakers to stick to their existing formulations.

“I suspect we will learn more and their approach may become clearer and/or evolve in coming days,” Goodman said. He added it makes sense to leave room for drugmakers to update to either strain, noting it’s often difficult to predict how Covid will evolve.

The updated Covid shots are still expected to be available in the fall to adults 65 and up and kids and adults with at least one medical condition that puts them at risk for severe illness — two groups that are exempt from the clinical trial requirement.

The list of underlying conditions that raises a person's risk is extensive — “physical inactivity” is even included. Officials estimated that more than 100 million people in the U.S. would still qualify for a shot.

But the clinical trial requirement “would clearly delay and impede access to vaccines for those people who want it,” said Dr. Jesse Goodman, a professor of medicine and infectious disease at Georgetown University and a former chief scientist at the FDA.

However, Goodman added, a number of questions remain about the FDA’s policy, including how many people would be needed for the trials and whether a new strain selection would indeed trigger the new trial requirement.

When asked by committee members about the new policy on Thursday, FDA officials either said that the questions were off-topic or that the agency was still finalizing the details with drugmakers.

The FDA’s notice also states it would “preferentially” like drugmakers to update their shots to the LP.8.1 strain — potentially leaving room for drugmakers to stick to their existing formulations.

“I suspect we will learn more and their approach may become clearer and/or evolve in coming days,” Goodman said. He added it makes sense to leave room for drugmakers to update to either strain, noting it’s often difficult to predict how Covid will evolve.

The Centers for Disease Control and Prevention will no longer recommend routine Covid shots for healthy children and pregnant women, Health and Human Services Secretary Robert F. Kennedy Jr. announced Tuesday.

“We are now one step closer to realizing @POTUS’s promise to Make America Healthy Again,” he said in a post on X.

Kennedy said the vaccine would no longer be recommended for "healthy pregnant women," but it was unclear who would qualify. The CDC lists pregnancy as a condition that puts people at high risk for Covid complications.

The change from the CDC comes a week after Food and Drug Administration Commissioner Dr. Marty Makary announced the agency planned to restrict the use of Covid shots to older adults and children and adults with underlying medical conditions.

New Covid shots for healthy children and adults will need to go through lengthy placebo-controlled clinical trials before they can get approved.

Kennedy has a long history of opposition to a variety of vaccines, including the Covid shot. In 2021, he filed a citizen petition requesting that the FDA revoke the authorization of the vaccines. The same year, he described the Covid vaccines as “the deadliest vaccine ever made,” specifically due to rare cases of myocarditis in young men. Studies have found that the risk of myocarditis is higher in people with a Covid infection and usually more severe than after vaccination.

Under Kennedy, the FDA slow-walked the approval of Novavax's shot before approving it earlier this month. In an unusual move, the FDA limited its use to people 65 and older and teens and adults with at least one condition that puts them at risk for severe illness.

There are no mandates in the U.S. for anyone to get the Covid shot.

But experts say that millions of people, even those who have had a previous Covid infection, still may need another dose because they are vulnerable to severe disease from the virus, particularly older adults, people with weakened immune systems and pregnant

At the height of the Covid pandemic, doctors reported an unprecedented surge in pregnant women hospitalized and in critical condition after a Covid infection.

Changes in a woman's immune system during pregnancy increases the risk of complications like pneumonia from many respiratory viruses, including Covid. Last month, researchers at Brown University School of Public Health published a study finding that maternal deaths spiked when the pandemic hit.

The American College of Obstetricians and Gynecologists said it was “extremely disappointed” by the HHS announcement.

“We have seen firsthand how dangerous Covid infection can be during pregnancy and for newborns who depend on maternal antibodies from the vaccine for protection,” the group wrote in a statement. “We also understand that despite the change in recommendations from HHS, the science has not changed. It is very clear that Covid infection during pregnancy can be catastrophic and lead to major disability.”

While Covid cases, including related hospitalizations and deaths, are currently low, the virus is still circulating.

"We still have children in our emergency department with Covid. When we see them, they have bronchiolitis or bronchitis," said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Pennsylvania. "Do they consider that not worthy of prevention?"

The CDC previously recommended Covid vaccines across the board for everyone 6 months and older.

“One of the things that I relied on as a pediatrician was an assurance that the recommendations that came to me were based on the best available science and evidence, and came from the work of the expert advisors to the CDC,” said Dr. Richard Besser, former acting director of the CDC and president of the Robert Wood Johnson Foundation.” This is clearly not coming from that direction, and that’s greatly concerning.”

Dr. Sean O’Leary, an infectious diseases expert with the American Academy of Pediatrics, said no one from HHS had consulted the leading pediatricians' group about Tuesday’s announcement.

Meanwhile, as of Tuesday afternoon, the CDC’s website recommended that “everyone 6 months and older” should get the Covid vaccine.

Will I be able to get a Covid shot this fall?
There are concerns among infectious disease and vaccine experts whether Covid vaccines will be available at all for fall. In 2024, boosters were approved by August, and they were widely available by October.

The FDA’s vaccine advisory committee met Thursday to make a recommendation on which strains should be included in the next round of shots. Summer waves of Covid have occurred each year since 2020 before rising again in the fall and winter during the typical flu season.

There's no indication yet that the U.S. is entering a wave this summer, but experts are keeping a close eye on the latest variant, called LP.8.1.

The variant is an Omicron offshoot. In February, the World Health Organization said that it was monitoring LP.8.1. As of May 10, it made up 70% of Covid cases in the U.S. The CDC was expected to provide a more current look at the variant breakdown May 24 but hasn't yet done so.

The WHO is also monitoring another variant, NB.1.8.1, which has been reported in several states.

The anticipated rollout of the shots this fall might be at risk after a significant change under guidance from Kennedy and Makary in how the vaccines are tested.

Under the change by Kennedy, all new vaccines will need to go through placebo-controlled clinical trials — where some people get the actual shot and others get something inactive, like a saline shot — to compare the results.

The original Covid vaccines, from Pfizer and Moderna, approved in late 2020, went through placebo-controlled trials.

When will Covid boosters be available?
If the FDA deems Pfizer’s and Moderna’s updated vaccines as “new” products, requiring fresh trials, it’s extremely unlikely doses would be ready for the fall for anyone, including seniors or the severely immunocompromised.

How much do Covid shots cost?
The CDC’s recommendation is crucial because it guides insurance companies on which vaccines to cover at no cost to patients.

Pfizer and Moderna are charging up to $150 per dose for a Covid vaccine, according to the CDC’s vaccine price list. The agency doesn’t list the cost of the Novavax vaccine, which was fully approved earlier this month.

Medicare and Medicaid require that the vaccines are free for patients. The Affordable Care Act, more commonly known as Obamacare, requires private insurers to cover all vaccines that are recommended by the CDC’s vaccine committee and director.

Children without insurance can get free vaccines through the government-run Vaccines for Children Program. But massive cuts to health care funding unveiled in March forced some local and state health departments to lay off staff and cancel vaccine clinics.

If the CDC stops recommending Covid vaccines for children or pregnant women, the question arises: Will private insurance or Medicaid continue to cover the cost of the new boosters?

"It will be a cascade of events,” Offit said. “It’ll be insurance companies may not pay for it, the vaccine for children’s program may not pay for it, but therefore more expensive, less available and less used.”